Ese ufite amaraso mu mubiri wawe nta mpamvu? Reka twige kuri iyi TTP iteje akaga (Thrombotic Thrombocytopenic Purpura)!

Ese wigeze wumva Thrombotic Thrombocytopenic Purpura, cyangwa TTP mu magambo ahinnye? Iyi ni indwara y'amaraso idasanzwe ariko ikomeye cyane. Ni indwara aho amaraso afungana (thrombi) mu mitsi mito y'amaraso mu mubiri wawe. Ni nk'aho amazi afunganye mu muyoboro w'amazi. Ibi bishobora kubuza amaraso gutembera mu ngingo z'ingenzi mu mubiri wawe, nko mu bwonko, mu mpyiko no mu mutima. Ibi bishobora guteza ibibazo bikomeye. Niyo mpamvu ari ngombwa kumenya TTP.

TTP ni iki? Reka dusobanukirwe gusa icyo izina risobanura.

Izina ry'iyi ndwara rishobora gusa nkaho ari rirerure gato. Ariko ibice bitatu by'iri zina biduha igitekerezo cyiza ku miterere y'iyi ndwara. Reka turebe uko imeze?

1. Kuziba kw'amaraso: Ibi bivuga ku kubumba kw'amaraso (thrombi) biba mu miyoboro y'amaraso, nk'uko nabivuze mbere. Uku kubumba kw'amaraso ni yo ntandaro y'ikibazo nyamukuru.

2. Thrombocytopenique: Ibi bivuze ko hari platelets nke mu maraso yawe. Platelets zimeze nk'abasirikare bato bafasha guhagarika kuva amaraso iyo twakomeretse. Ariko iyo TTP ibayeho, izi platelets zikoreshwa bitari ngombwa kugira ngo amaraso agire ibice. Hanyuma nta platelets zihagije zibaho aho kuva amaraso bigomba guhagarara.

3. Purpura: Ibi bivuze ko uruhu rwawe rugira utudomo duto, tw’umuhengeri cyangwa ibisebe. Bishobora kumera nk’ibisebe. Mu by’ukuri ibi ni ibimenyetso by’amaraso make munsi y’uruhu. Ibi bikunze kugaragara ku bantu bafite TTP.

Muri make, TTP ni indwara ikomeye aho amaraso acika mu mitsi mito y'amaraso y'umubiri wacu, bigatuma habaho platelets nkeya n'ibimenyetso byo kuva amaraso mu ruhu. Ibi bikunze kubaho mu buryo butunguranye, bityo ni ngombwa kwivuza byihutirwa . Hari abantu bashobora kongera kugira iyi ndwara ndetse na nyuma yo kuvurwa. Ariko, ibimenyetso akenshi biragaragara iyo indwara itangiye. Hari igihe ishobora guterwa n'ibintu nk'ubwandu bwa virusi, kubagwa, cyangwa gutwita. Iyo itavuwe, TTP ishobora gushyira ubuzima mu kaga.

Ni ibihe bimenyetso bya TTP?

TTP ikunze kugaragara vuba cyane. Hari abantu bakira hanyuma bagasubira inyuma, ariko ibimenyetso ntibigaruka. Bihoraho kandi biragaragara. Ntibishira ubwabyo, kandi birakenewe kuvurwa.

TTP ituma amaraso acika mu mitsi mito y'amaraso mu mubiri wose. Ayo maraso ashobora kugira ingaruka ku rugingo urwo arirwo rwose, ariko ibimenyetso akenshi bitangira kugaragara mu bwonko.

Tekereza, niba ibi bice by'amaraso byibasira umutima, bishobora kugira ingaruka zikomeye ku mikorere y'umutima, ndetse bikaba byanatera urupfu. TTP itera kubura amaraso (umubare muto w'amaraso) n'urugero ruto rw'ibinure (thrombocytopenia). Hari abantu bashobora no kuva amaraso, ariko ibi ntibikunze kubaho cyane.

Dore bimwe mu bimenyetso bikunze kugaragara bya TTP:

• Imitekerereze yahindutse: Guhungabana mu buryo butunguranye, urujijo, cyangwa guta ubwenge.
• Urujijo: Kutamenya ibiri kuba cyangwa aho uri.
• Umunaniro ukabije: Kumva unaniwe cyane ku buryo ntacyo ushobora gukora.
• Umutwe: Umutwe ukabije kurusha umutwe usanzwe.
• Isesemi no kuruka: Kubabara mu nda, kuruka.
• Uruhu rwerurutse cyangwa umuhondo (Jaundice): Uruhu rushobora guhinduka ibara bitewe n'ibura ry'amaraso mu mubiri, ndetse rushobora no guhinduka umuhondo bitewe n'ingaruka ku mwijima.
• Guhumeka bigoranye (Dyspnea): Kumva bigoye guhumeka.
• Utudomo duto dutukura cyangwa umuhengeri munsi y'uruhu (Petechiae): Utudomo duto tw'amaraso tugaragara ku ruhu, nk'aho twakubiswe n'agapira.
• Hematuria: Amaraso mu nkari .
• Impinduka mu kureba: Kubona nabi, rimwe na rimwe kubona ibintu bibiri icyarimwe (diplopia).

Niba ugize kimwe cyangwa byinshi muri ibi bimenyetso mu buryo butunguranye, ugomba kujya kwa muganga nta gupfusha ubusa umwanya.

Kuki iyi TTP iba? Ni izihe mpamvu?

Udukoko tw’amaraso dutera ibibazo muri TTP tubaho iyo umubiri ubuze enzyme yitwa ADAMTS13 ihagije. Icyo iyi enzyme ya ADAMTS13 ikora ni ukubuza platelets kwishyira hamwe no gukora udukoko tw’amaraso iyo tutabikeneye. Tekereza nk'umupolisi wo mu muhanda, ukirinda umuvuduko w'imodoka utari ngombwa. Rero, iyo iyi ADAMTS13 igabanutse, udukoko tw’amaraso dutangira kwirema mu mitsi mito y’amaraso mu mubiri wose. Iyo utu dukoko tw’amaraso duhuye, ndetse n’uturemangingo dutukura tw’amaraso dushobora gucika no kuvunika.

Kubera ko platelets nyinshi zikoreshwa mu gukora amaraso adakenewe, mu gihe dukeneye guhagarika kuva amaraso bitewe n'igikomere, hasigaye platelets nke cyane zo gukoresha. Iyo umubare wa platelets zawe ugabanutse cyane, ushobora gukomereka byoroshye no kuva amaraso menshi kuruta uko bisanzwe.

TTP ishobora kubaho mu buryo bubiri bw'ingenzi:

1. Gufata TTP (iyi ni yo ikunze kugaragara): Iki ni cyo gihe ubudahangarwa bw'umubiri wawe bwite bukora nabi ubudahangarwa bw'umubiri bubuza enzyme ya ADAMTS13 gukora neza. Ni nk'aho abasirikare bawe ubwabo biyitera.

2. TTP irazwe (idasanzwe): Ibi bibaho iyo umwana avukanye inenge muri gene ikora ADAMTS13 enzyme iva ku babyeyi bombi. Ibimenyetso bikunze gutangira mu gihe cyo gutwita cyangwa mu bihe by'imihangayiko ikomeye.

Ese hari impamvu zihariye zishobora gutuma TTP ibaho?

Impuguke ntiziramenya neza icyatera ibimenyetso bya thrombocytopenic purpura mu maraso. Ariko, hari abantu bashobora kurwara iyi ndwara iyo:

• ubwandu bwa virusi itera SIDA
• Indwara z'ubudahangarwa bw'umubiri nka lupus
• Gutwita
• Imiti imwe n'imwe, urugero nk'imiti ya chimiotherapie , cyclosporine A , na quinine .

Ni izihe ngorane zishobora guterwa na TTP?

Indwara ya Thrombotic thrombocytopenic purpura ni indwara ishobora gushyira ubuzima mu kaga iyo itavuwe. Indwara yo kuzura amaraso ishobora kubuza amaraso gutembera no guteza ingorane zikomeye, nka:

• Kwangirika k'ubwonko
• Indwara y'umutima
• Indwara y'impyiko idakora neza
• Gukuramo inda (Gutakaza inda)
• Indwara zo mu mutwe
• Igisebe cy'imitsi

Niyo mpamvu tuvuga ko ari ingenzi cyane kwihutira kwivuza niba ufite ibimenyetso bya TTP.

Ni gute abaganga basuzuma TTP?

Muganga wawe azabanza kugusuzuma no kukubaza ibimenyetso byawe n'amateka y'ubuzima bwawe. Niba bikekwa ko hari TTP, bashobora kugutegeka ibipimo byinshi, nko:

• Isuzuma rya ADAMTS13: Iki kizamini gipima imikorere ya enzyme ya ADAMTS13. Iyo urugero rwayo ruri hasi, ishobora kwemeza ko TTP ihari.
• Umubare wuzuye w'amaraso (CBC): CBC ibarura ubwoko bw'uturemangingo mu maraso yawe. Abantu barwaye TTP bafite umubare muto w'uturemangingo dutukura mu maraso n'uturemangingo duto.
• Gupima amaraso mu maraso (PBS): Ibi bikubiyemo gufata icyitegererezo cy'amaraso yawe no kuyasuzuma ukoresheje mikorosikopi. Niba ufite TTP, uturemangingo tw'amaraso dutukura dushobora kuvunika no gucikagurika (byitwa schistocytes ).
• Ikizamini cya Bilirubin: Bilirubin ni imyanda ikorwa n'uturemangingo dutukura twangiritse. Ingano nyinshi ya bilirubin ni kimwe mu bimenyetso bigaragaza ko ushobora kuba ufite TTP.
• Ibizamini by'imikorere y'impyiko: Ibi bizamini bishobora gufasha muganga wawe kureba niba impyiko zawe zikora neza. Niba ufite TTP, ushobora kuba ufite uturemangingo tw'amaraso cyangwa poroteyine mu nkari zawe.
• Ikizamini cya Lactate dehydrogenase (LDH): Lactate dehydrogenase (LDH) ni enzyme irekurwa iyo ingingo z'umubiri wawe zangiritse. TTP itera urugero rwinshi rwa LDH mu maraso.

Ni ubuhe buryo bwo kuvura TTP?

Kenshi na kenshi, abaganga bakoresha ubuvuzi bwa plasma mu kuvura TTP. Byongeye kandi, hari imiti ivura.

Uburyo bwo kuvura plasma

Uburyo bukunze gukoreshwa cyane ni ubu:

• Guhinduranya plasma: Ibi bikubiyemo gukuraho plasma yawe idasanzwe (igice cy'amazi mu maraso yawe) hanyuma ukayisimbuza plasma ivuye ku muntu muzima uyitanga. Ubu ni uburyo bwo kuvura burokora ubuzima ku bantu bafite TTP.
• Corticosteroids: Iyi miti ifasha mu kugenzura TTP ikabije, kugabanya ibimenyetso, no kugabanya kubyimba.

Ubuvuzi bwa plasma butangwa mu bitaro kandi bushobora gukomeza iminsi cyangwa ibyumweru kugeza igihe ibimenyetso byawe birangiye.

Umuti

Hari imiti imwe n'imwe ishobora kugabanya cyangwa guhagarika ikorwa ry'uturemangingo dutera ADAMTS13 (uturemangingo dutera ADAMTS13). Imwe mu miti abaganga bakoresha mu kuvura TTP ni:

• Glucocorticoids: Ubu buryo bwo kuvura bugabanya ubudahangarwa bw'umubiri wawe. Ibi bishobora kuba ingirakamaro kuri TTP.
• Caplacizumab: Uyu muti uvura TTP ikabije. Wongera umubare wa platelets vuba kurusha ihererekanya rya plasma ryonyine, bigafasha gusubiza indwara vuba.
• Rituximab: Ubu buryo bwo kuvura bufasha kwirinda ko iyi ndwara yongera kugaruka nyuma yo gufata imiti ya corticosteroid na plasma.
• ADAMTS13 ikora ibikomoka kuri recombinant: Ubu buryo bwo kuvura busubizaho enzyme ya ADAMTS13. Byemejwe n'Ikigo gishinzwe ibiribwa n'imiti muri Amerika (FDA) kugira ngo bukoreshwe mu buryo bwihutirwa ku bantu bafite TTP gakondo. Hari igihe abaganga bayikoresha kugira ngo birinde kuva amaraso menshi. Ubushakashatsi burakomeje kugira ngo harebwe akamaro kayo kuri TTP iterwa n'ubudahangarwa bw'umubiri.

Kubaga

Ni gake cyane, muganga wawe ashobora kukugira inama yo kubaga agakuramo agashishwa kawe k'inkari (spleenectomy). Ibi bikorwa gusa iyo ufite TTP ikomeye idakira neza mu kuvurwa cyangwa iyo ikomeje kugaruka.

Bifata igihe kingana iki kugira ngo umuntu akire nyuma yo kuvurwa na TTP?

Igihe cyo gukira giterwa n'ibintu byinshi. Uburemere bw'indwara yawe n'ubwoko bw'ubuvuzi uhabwa bishobora kugira ingaruka kuri ibi. Abantu benshi bahabwa ubuvuzi bwa plasma bwa TTP bifata iminsi mike kugeza ku byumweru bike kugira ngo bakire. Abantu bakorewe ibizamini bya splenectomy ubusanzwe bifata ibyumweru bine kugeza kuri bitandatu kugira ngo bakire.

Ni ryari nkwiye kujya kwa muganga niba nkeka ko mfite TTP?

Ibimenyetso bya TTP akenshi birakomeye cyane ku buryo bisaba kujya mu cyumba cy’ubutabazi bw’ibanze. Niba ukeka ko ufite TTP, ntutegereze kujya kwa muganga usanzwe - kuvurwa byihutirwa ni ngombwa!Ubuhanga bw'abaganga b'indwara z'amaraso n'inzobere mu by'ubuvuzi bw'inyongera ni ingenzi mu kuvura indwara ya TTP ikabije.

Ni iki wakwitega mu gihe ubana na TTP? Ni iki giteganyijwe kugira ngo uruhuke?

TTP yari indwara yica abantu benshi. Ariko iyo ivuwe hakiri kare, igipimo cy'impfu cyaragabanutse kigera kuri 10%. Kubera ko iyi ndwara ishobora kugaruka, ni ngombwa gukomeza kuba hafi y'umuganga w'amaraso ndetse na nyuma yo kuvurwa. Gusuzuma buri gihe urugero rwa ADAMTS13 bishobora gufasha kumenya impinduka hakiri kare. Niba urugero rwa ADAMTS13 ruri hasi mbere yuko ibimenyetso bigaruka, uburyo bwo kwirinda nka Rituximab bushobora gufasha guhagarika iyi ndwara kugaruka mbere yuko itangira.

Igipimo cyo kubaho cya TTP ni ikihe?

Iyo umuntu umwe gusa ku icumi arwaye TTP adahawe umuti, ni we urokoka. Ariko iyo umuntu avuwe neza, umunani kugeza ku icyenda ku icumi ni we ushobora kurokoka.

Niyo mpamvu ari ngombwa gushaka ubuvuzi niba ufite ibimenyetso. Ni ngombwa kandi gukurikiza amabwiriza ya muganga wawe y'uko wakwitaho nyuma yo gupimwa.

Iyo abantu benshi bafite uburwayi bwa Thrombotic Thrombocytopenic Purpura (TTP) babaho ubuzima busanzwe. Muganga wawe azagusobanurira inshuro ugomba gukorerwa ibizamini kugira ngo akurikirane uko umerewe. Azakubwira kandi niba ukeneye kuvurwa buri gihe kugira ngo ugabanye ibyago byo kuva amaraso no kubyimba kw'amaraso.

Hagati aho, niba ufite ibimenyetso bya TTP, shaka ubuvuzi bwihuse. TTP ni ikibazo cyihutirwa cy’ubuvuzi. Ariko kuvurwa hakiri kare bishobora kurokora ubuzima bwawe.

None se, ni ikihe kintu cy'ingenzi cyane ugomba kwibuka mu byo twavuze?

Twavuze byinshi kuri TTP (Thrombotic Thrombocytopenic Purpura). Ibintu by'ingenzi ugomba kuzirikana ni ibi bikurikira:

• TTP ni indwara idakunze kugaragara ariko ikomeye cyane y’amaraso aho amaraso acika mu mitsi mito y’umubiri.
• Niba ugize ibimenyetso nko kwitiranya ibintu mu buryo butunguranye, kuribwa umutwe cyane, ibibara by'umuhengeri ku ruhu, cyangwa kugaragara nk'uruhu rudafite ibara, bishobora kuba ari TTP. Ntugapfushe umwanya kandi ujye kwa muganga ako kanya.
• Ibi ntibizakira ubwabyo. Ubuvuzi bwihutirwa burakenewe rwose.
• TTP ishobora gukira iyo imenyekanye hakiri kare kandi ikavurwa neza. Hamwe n'ubuvuzi bugezweho buboneka muri iki gihe, amahirwe yo gukiza ubuzima ari menshi cyane.
• Ndetse na nyuma yo kuvurwa, kurikiza amabwiriza ya muganga kandi wipimishe. Ibi bizagufasha kwirinda ko indwara yongera kugaruka.

Niba wowe cyangwa umuntu uzi ukeka ikintu nk'iki, ntugatinye. Ariko gira icyo ukora vuba. Gushaka inama kwa muganga ni cyo kintu cyiza cyo gukora. Komeza ugire ubuzima bwiza!

` Thrombotic Thrombocytopenic Purpura, TTP, indwara y'amaraso, kubumba amaraso, platelets, ibimenyetso, uburyo bwo kuvura